Vaginal cancer

Overview

The vagina is the passageway through which fluid passes out of the body during menstrual periods. It is also called the birth canal. The vagina connects the cervix (the opening of the womb, or uterus) and the vulva (the external genitalia). Cancer of the vagina, a rare kind of cancer in women, is a disease in which malignant (cancer) cells are found in the tissues of the vagina.

There are several types of cancer of the vagina. The two most common are:

  • Squamous cell cancer (squamous carcinoma):
    • Squamous carcinoma is most often found in women older than age 60, and accounts for about 70 percent of all vaginal cancers.
  • Adenocarcinoma:
    • Adenocarcinoma is more often found in women older than 50 and accounts for about 15 percent of all vaginal cancers.
    • A rare form of cancer called clear cell adenocarcinoma results from the use of the drug DES (diethylstilbestrol) given to pregnant women between 1940 and 1971 to keep them from miscarrying. It occurs most often in the daughters of the women who took DES. 

Other, less common types of cancer that can be found in the vagina include: 

  • Malignant melanoma
  • Leiomyosarcoma
  • Rhabdomyosarcoma
  • Cancers that begin in other organs (such as the cervix and rectum) and spread to the vagina.

Our approach

With one of the largest gynecologic oncology programs in the New York metropolitan region, Northwell Health takes a comprehensive approach to treating women with cancer of the reproductive organs, including vaginal cancer. The specialists work together — and with each patient — to plan the most effective course of vaginal cancer treatment using the latest, research-backed therapies available.

At Northwell Health, the physicians combine the most advanced diagnostic technologies, promising therapies and sophisticated surgical options with an extensive array of support programs designed to nurture and heal the whole person.

Highlights of vaginal cancer treatments and services include:

  • The latest technology to diagnose and treat both early-stage and recurrent vaginal cancers
  • The latest surgical innovations — with an emphasis on minimally invasive, fertility-sparing and reconstructive techniques
  • Innovative vaginal cancer treatments, including targeted therapies
  • An extensive clinical trials program, offering access to the latest treatment options

Multidisciplinary Vaginal Cancer Treatment

Within the first several days of a visit, the team will conduct a complete array of tests and develop a personalized vaginal cancer treatment program.

Each vaginal cancer diagnosis is unique, so the team meets regularly to discuss the individual treatment approach during weekly multidisciplinary conferences which allow the physicians to discuss best options for delivering highly specific and fully explored collaborative patient care. Each phase of a patient’s treatment is reviewed by the team, to ensure that treatment milestones are reached.

Risk factors

The following have been suggested as risk factors for vaginal cancer:

Symptoms

The following are the most common symptoms of vaginal cancer. However, each individual may experience symptoms differently. Symptoms may include:

  • Bleeding or discharge not related to menstrual periods
  • Difficult or painful urination
  • Pain during intercourse
  • Pain in the pelvic area
  • Constipation
  • A mass that can be felt

Even if a woman has had a hysterectomy, she still has a chance of developing vaginal cancer. The symptoms of vaginal cancer may resemble other conditions or medical problems. Consult a doctor for diagnosis.

Diagnosis

The first step in making a diagnosis of vaginal cancer is usually a physical, during which a doctor will perform a pelvic exam and review personal and family medical history. If vaginal cancer is suspected, the patient will be referred for further tests. 

There are several tests used to diagnose vaginal cancer, including:

  • Pelvic exam — An exam of the vagina, cervix, uterus, fallopian tubes and ovaries.
  • Pap smear (pap test) — An examination of the vulva, vagina, cervix, uterus, ovaries and fallopian tubes and rectum. The doctor may use a speculum, a tool that holds open the sides of the vagina, to examine the cervix and scrape a sample of cells from the outside of the cervix and vagina.
  • Vaginal biopsy — A tissue sample is taken by pinching off a small amount of vaginal tissue. A pathologist examines the tissue under a microscope to determine whether cancer is present. 
  • Colposcopy — A lighted, magnifying instrument is used to check the vagina and cervix for abnormal areas. Tissue samples may be taken and checked for signs of disease.

Staging

Once a vaginal cancer diagnosis has been confirmed, a doctor may conduct one or more of the diagnostic imaging tests listed above to determine the location of the cancer and how far it has spread.

This process is called staging. The stages of uterine cancer include:

  • Stage I: Cancer is found in the vagina wall only.
  • Stage II: Cancer has spread through the wall of the vagina to the tissue around the vagina, but has not spread to the walls of the pelvis.
  • Stage III: Cancer has spread to the walls of the pelvis.
  • Stage IV: Cancer has spread to:
    • The lining of the bladder, rectum and beyond the pelvis area.
    • The parts of the body not near the vagina, such as a bone or lung.                                                                                                                    

Staging is necessary in order to design the most effective treatment plan.

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